Express Scripts Could Negotiate Drug Rebates For 100m Lives With Prime Therapeutics Deal
Manufacturers will face the “biggest PBM ever” in price negotiations for pharmacy benefit drugs as a result of the collaboration between the two pharmacy benefit managers.
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Hybrid approach to pharmacy benefit management expected to save insurer $4bn annually after Anthem ends its relationship with Express Scripts in 2020. Integration of medical and Rx benefit data could lead to more value-based contracting.
Temporary policy may open door to longer term change as Medicare allows reimbursement of at-home administration of non-hospital drugs covered by Part B under a recently-released regulation aiding at encouraging telehealth during the coronavirus outbreak.
Biopharma is working on a reputation renaissance as the public looks to industry for treatments and vaccines for the COVID-19 epidemic and drug pricing concerns take a back seat.